1.Prognostic value of post-mastectomy radiation therapy in node-positive breast cancer patients treated with breast conservation therapy
Ying ZHENG ; Qin CHEN ; Miaomiao JIA ; Zhijie LIANG ; Xuchen CAO
Chinese Journal of Clinical Oncology 2014;(21):1394-1398
Objective:To evaluate the prognostic value of post-mastectomy radiation therapy (PMRT) in patients with axillary lymph node-positive breast cancer treated with breast conservation surgery and to establish the candidates for PMRT based on different pN stages and lymph node ratios (LNR). Methods:A retrospective analysis of the clinical data of the patients was conducted. The pa-tients had positive lymph nodes (n=152) between 1998 and 2007 and underwent breast conservation surgery. A comparison of the dis-ease-free survival (DFS) and overall survival (OS) rates was conducted based on LNR and pN staging and with PMRT as a prognostic factor. Results:A total of 152 cases were studied, of which 114 were pN1, 23 were pN2, and 15 were pN3. Among these cases, 114 had an LNR ranging from 0.01 to 0.20, 26 had an LNR from 0.21 to 0.65, and 12 had an LNR>0.65. Univariate analysis showed that the number of dissected lymph nodes, LNR, pN stage, estrogen and progesterone receptor status, and radiotherapy were the prognostic fac-tors for DFS and OS rates (P<0.05). Age and chemotherapy were prognostic factors only for OS rate (P<0.05). Multivariate analysis in-dicated that PMRT and LNR were independent prognostic factors of DFS and OS (P<0.05). The pN staging had no significant effect on DFS or OS (P>0.05). In the subgroup analysis, PMRT had significant effect on DFS and OS (P<0.05) in patients with pN1 and LNR<0.21. Conclusion:LNR is an independent prognostic factor in axillary lymph node-positive breast cancer patients treated with breast conservation surgery, and a candidate for PMRT should be established based on different LNR risks.
2.Effect of health check-up on early detection of colorectal or breast cancer
Minlu ZHANG ; Zhuping FAN ; Qin CAO ; Ying ZHENG
Chinese Journal of Health Management 2014;8(5):310-315
Objective To explore the effect of health check-up on screening and early detection of colorectal or breast cancer.Methods A total of 4 179 health check-up receivers were enrolled in this investigation.Basic health information was linked to the Shanghai Cancer Registry System and confirmed cancer diagnosis through Access 2007.Excel 2013 was used to analyze cancer detection rate,ranking,age and sex distribution and early stage proportion.Results During 2011 and 2012,81 cancer cases were identified,with a detection rate of 47.47/100 000.The highest detection rate was found in 60-69 years old group (105.36/100 000),and male:female ratio was 1.25 ∶ 1.One colorectal cancer was diagnosed,resulting in a detection rate of 0.79/100 000.Eleven breast cancers were diagnosed,with a detection rate of 17.22/100 000.Early stage breast cancer accounted for 71%,which was higher than average level between 2005-2009 (33%).Conclusion Detection rate of colorectal cancer among health check-up receivers was very low,which is inconsistent with the high incidence of colorectal cancer in Shanghai.Fecal occult-blood test should be performed during health check-up,which may increase colorectal cancer detection.Moreover,health check-up may contribute to early detection of breast cancer.
3.Roles and resistance mechanisms of survivin in tumor
Ying ZHENG ; Qin CHEN ; Bin ZHANG ; Xuchen CAO
Journal of International Oncology 2014;41(4):241-244
Drug resistance in tumor treatment is an important factor that affects disease outcome.A lot of researches show that survivin can inhibit tumor cell apoptosis,regulate cell cycle,promote angiogenesis and tumor metastasis.The interactions among survivin,genes and proteins can influence the drug resistance of tumor cells.
4.Role of SHP2 in invasion and metastasis of breast cancer
Qin CHEN ; Ying ZHENG ; Bin ZHANG ; Xuchen CAO
Chinese Journal of Clinical Oncology 2014;(15):999-1002
Src homology 2 domain-containing phosphatase (SHP2), which is encoded by proto-oncogene PTPN11, is one of the transmembrane protein-tyrosine phosphatases. SHP2 has an important function in signal transduction pathways and activities of cells through the regulation of tyrosine phosphorylation level of intracellular proteins. The status of SHP2 activation is closely connected with the regulation of hormone levels, state of invasion and metastasis of tumor, development and progression of tumor stem cells of breast cancer, as well as signal pathways including Ras/ERK and PI3K/Akt/mTOR. Gene knockout or gene silencing expression helps inhibit tumor growth, irreversibly hindering the ability of the tumor to regain stem cells and disturb the signal pathways of the invasion and metastasis of breast cancer. Recent studies have shown that SHP2 may help in bringing anticancer drugs to a higher level. This arti-cle concentrates on the research progress in relationship of SHP2 with invasion and metastasis of breast cancer.
5.Clinical features and mutation analysis of LRRK2 gene in patients with autosomal dominant familial Parkinson's disease
Ting ZHANG ; Li CAO ; Ying WANG ; Qin XIAO ; Jing ZHANG ; Xijin WANG ; Lan ZHENG ; Shengdi CHEN
Chinese Journal of Neurology 2008;41(3):152-156
Objective To investigate the clinical features and LRRK2 gene mutation in patients with autosomal dominant familial Parkinson's disease (PD). Methods The clinical features of 16 autosomal dominant familial PD probands were analyzed in terms of age at onset, onset symptoms, UPDRS scores, response to the levodopa treatment and drug-induced dyskinesia. The LRRK2 gene exons 5,13,31,32,35,37,41 and 48 of 16 probands were sequenced after polymerase chain reaction. The novel mutation was further screened in 24D sporadic PD patients and 214 controls using PCR-RFLP for the genotypo frequency analysis. Results Clinically, most of 16 probands had late-onset age. Resting tremor (9patients, 56. 25%,t=0.558,P=0.679)and bradykinesia (9 patients,56.25%,t=0.369,P=0.454)were common onset symptoms followed by rigidity(6 patients,37.50%,t=1.324,P=0.735)and postural instability(5 patients,31.25%,t=2.369,P=0.956).Majority of them had good response to levedopa treatment and rare occurrence of drug-induced dyskinesia. Among the 16 autosomal dominant familial PD probands,6 variants were identified:c.457 T>C(Leu153Leu),c.1432 G>T(Asp478Tyr),c.5457 T>C(Gly1819Gly),c.7153 G>A(Gly2385Arg),IVS31+28 T>G and IVS37+162 T>C. The c.1432G>T(Asp478Tyr)variant was a novel mutation and it was not detected in 240 sporadic PD patients and 214 controls. The reported mutations associated with the PD, such as Arg1441 Cys/Gly/His, Arg1514Gln, Tyr1699Cys, Ile2012Thr, Gly2019Ser and Ile2020Thr,were not found in our study. Conclusions The autosomal dominant familial PD patients present with classical symptoms of PD and bear the LRRK2 variantsAsp478Tyr and Gly2385Arg.
6.Application of percutaneous transhepatic cholangial drainage and percutaneous transhepatic cholangial stent implantion in treating malignant biliary obstruction in elderly patients
Linbo ZHANG ; Haishan YANG ; Shu CAO ; Sheng FAN ; Ying QIN ; Qingyu LIU
Tumor 2010;(2):152-155
Objective:To evaluate the clinical value of percutaneous transhepatic cholangial drainage (PTCD) and percutaneous transhepatic cholangial stent(PTCS)implantation therapy for malignant biliary obstruction in the elderly patients.Methods:Fifty three patients over 60 years-old were treated with PTCS implantation (n=35),PTCD for internal-external drainage(n=11),or single external drainage(n=7). The imaging examination was performed for all the patients one week after surgery. The serum levels of total bilirubin (TBIL) and alanine aminotransferase (ALT) were detected before and after surgery.Rusults:Metallic stents were successfully implanted in 32 patients during the surgery, and 3 patients were implanted 5 to 7 days later after PTCS. Both total serum levels of TBIL and ALT were significantly decreased at one week after surgery (P<0.05). The mean survival periods were 11.5 months for stent implantation patients and 5.5 months for PTCD patients. Conclusion:PTCD and PTCS are easy to perform and safe and effective in the treatment of malignant biliary obstruction of elderly patients.
7.Effects of post-mastectomy radiation therapy on T1-2 stage and one to three positive lymph node breast cancer patients with differ-ent risk factors
Zhijie LIANG ; Miaomiao JIA ; Qin CHEN ; Jing WANG ; Ying ZHENG ; Lingmei LI ; Xuchen CAO
Chinese Journal of Clinical Oncology 2014;(8):498-502
Objective:To retrospectively evaluate the prognostic risk factors of T1-2 stage breast cancer patients with one to three positive node(s) and their effects on the benefits of post-mastectomy radiation therapy (PMRT). Methods:We retrospectively analyzed 457 breast cancer patients with T1-2 stage and one to three positive axillary lymph nodes treated in our hospital between 2000 and 2002. The independent prognostic factors of the patients were calculated by the Cox proportional hazards model. The patients were fur-ther classified into high-risk and low-risk subgroups according to the risk factors to explore the benefit of PMRT on the prognosis of dif-ferent subgroups using survival analysis. Results:PMRT was not an independent beneficial factor of overall survival (OS) (HR=0.949;CI:0.435-2.074;P=0.896) or loco-regional recurrent free survival (LRRFS) (HR=0.611;CI:0.231-1.614;P=0.320) in all patients. Ex-tracapsular extension (ECE) and pathological grades were independent prognostic risk factors, and the benefits of PMRT were signifi-cantly different on the prognosis of high-risk subgroup patients (group ECE+OS:P=0.020, LRRFS:P=0.014;group GradeⅢOS:P=0.002, LRRFS:P<0.001). Meanwhile, PMRT failed to prolong the OS and LRRFS of low-risk subgroup patients (group ECE+OS:P=0.353, LRRFS:P=0.796;group GradeⅠtoⅡOS:P=0.267, LRRFS:P=0.589). Conclusion:ECE and gradeⅢwere the independent risk factors of death and loco-regional recurrence in the T1-2 breast cancer patients with one to three positive lymph node(s). PMRT was an effective adjuvant therapy to improve the prognosis of patients with high-risk factors. However, the benefit of PMRT had no sig-nificance in patients with ECE-or gradeⅠ-Ⅱ.
9.Clinical investigation on characteristics of traditional Chinese medical syndrome of hepatocirrhosis
Qin ZHANG ; Ping LIU ; Huifen CHENG ; Liang CHEN ; Suhua CAO ; Ying LIU ; Jianjun WEI ; Zhihong FANG ; Dingzhong WU
Journal of Integrative Medicine 2003;1(2):108-12
OBJECTIVE: To explore the characteristics of traditional Chinese medical syndrome (TCM syndrome) of hepatocirrhosis. METHODS: Clinical information from the four diagnosis methods of traditional Chinese medicine (TCM) and related laboratorial indexes were systematically collected from 223 hepatocirrhosis cases, and the multi-statistical methods including systematic cluster analysis, principal component analysis, stepwise discrimination and variance analysis were made with the software SAS 6.11. RESULTS: Multi-analysis showed that there were 3 categories of syndrome characteristics. Type 1 (134 cases): damp heat, blood stasis, deficiency of liver and spleen Qi; Type 2 (62 cases): deficiency of both Qi and Yin with severe deficiency of Qi, heat with severe dampness, blood stasis; Type 3 (27 cases): deficiency of both Qi and Yin with severe deficiency of Yin, stasis and heat or dampness. Analysis of the changes of the related laboratorial indexes among the three types of syndrome showed that Type 1 mainly manifested asthenia syndrome with sthenia syndrome, and its indexes of AST, ALT, GGT levels were markedly higher than those of Type 2 and Type 3, both of which mainly showed sthenia syndrome with asthenia syndrome, and that Type 3 was in active inflammation, deficiency of both Qi and Yin (deficiency of Yin > deficiency of Qi), and its FN, Alb, FV, FVII, PLT, PCT levels were obviously reduced. CONCLUSION: The multi-statistical methods can reveal the characteristics and regularity of TCM syndrome of hepatocirrhosis, and the 3 categories of syndrome characteristics basically conform to clinical manifestations. The result of TCM syndrome distribution and laboratorial indexes infer that damp heat is the pathological basis of hepatocirrhosis, and the degree of liver function disorder and liver damage may be the pathological basis of deficiency of Yin of both liver and kidney.
10.Grade of membership analysis of multidimensional health status in adult twins
Yan NING ; Wenyan JI ; Yonghua HU ; Yueqin HUANG ; Weihua CAO ; Jun LV ; Ying QIN ; Zengchang PANG ; Shaojie WANG ; Liming LI
Chinese Journal of Disease Control & Prevention 2009;0(02):-
Objective To construct profiles of health status based upon physical,mental and social support items in adult twins of Qingdao.Methods Grade of Membership(GoM) model was applied to a set of 31 indicators to construct ideal profiles.Results Four health profiles were identified: pure type Ⅰ(healthy),pure type Ⅱ(personality disorders),pure type Ⅲ(psychological symptoms) and pure type Ⅳ(physiological symptoms).The most frequently occurring combination in this population was profile Ⅰ,Ⅱ,Ⅳ(14.74%),followed by profile Ⅰ,Ⅱ,Ⅲ,Ⅳ(13.44%),and then type Ⅰ(11.08%).Only 13.56% of subjects fell completely into one single pure type.Conclusions One healthy type and three non-healthy types are determined.Most individuals exhibit some of the characteristics of two or more types,holding partial membership in multiple categories.